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treatment maternal sepsis

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https://www.readbyqxmd.com/read/29881638/chlorhexidine-vaginal-preparation-versus-standard-treatment-at-caesarean-section-to-reduce-endometritis-and-prevent-sepsis-a-feasibility-study-protocol-the-preps-trial
#1
V Hodgetts Morton, A Wilson, C Hewitt, A Weckesser, N Farmer, D Lissauer, P Hardy, R K Morris
Background: Worldwide caesarean section (CS) delivery is the most common major operation. Approximately 25% of pregnant women undergo a CS in the UK for delivery of their babies. Sepsis and post-natal infection constitute significant maternal mortality and morbidity. Infection following a CS has a number of primary sources including endometritis occurring in 7-17% of women. Sepsis reduction and reduction in antibiotic use have been identified as a national and international priority. The overarching aim of this research is to reduce infectious morbidity from caesarean sections...
2018: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/29862053/appropriate-and-timely-antibiotic-administration-for-neonatal-sepsis-in-mesoam%C3%A3-rica
#2
Herbert C Duber, Emily A Hartford, Alexandra M Schaefer, Casey K Johanns, Danny V Colombara, Emma Iriarte, Erin B Palmisano, Diego Rios-Zertuche, Paola Zuniga-Brenes, Bernardo Hernández-Prado, Ali H Mokdad
Neonatal sepsis is a leading cause of mortality among children under-5 in Latin America. The Salud Mesoamérica Initiative (SMI), a multicountry results-based aid programme, was designed to improve maternal, newborn and child health in impoverished communities in Mesoamérica. This study examines the delivery of timely and appropriate antibiotics for neonatal sepsis among facilities participating in the SMI project. A multifaceted health facility survey was implemented at SMI inception and approximately 18 months later as a follow-up...
2018: BMJ Global Health
https://www.readbyqxmd.com/read/29792103/prolonged-use-of-antibiotics-after-birth-is-associated-with-increased-morbidity-in-preterm-infants-with-negative-cultures
#3
C Fajardo, B Alshaikh, A Harabor
BACKGROUND: Most preterm infants are exposed to a variable duration of antibiotic therapy after birth despite negative cultures. Data is emerging about the risks of prolonged antibiotics. We sought to assess the association between length of initial antibiotic course and neonatal outcomes in a cohort from a single large perinatal centre. METHODS: Retrospective cohort study of prospectively collected data on all infants with a birth weight of less than 1250 g hospitalized in our NICU in a 4-year window and who had negative blood and CSF cultures in the first 2 days of life...
May 23, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29733491/recognition-and-treatment-of-sepsis-in-pregnancy
#4
Anthony M Kendle, Judette Louis
Sepsis that occurs in the context of pregnancy is associated with significant maternal morbidity and mortality. International and multidisciplinary organizations have advocated for expedient diagnosis and initiation of treatment in patients with sepsis. However, the physiologic changes of pregnancy complicate both identification and treatment of maternal sepsis. This article describes a case of a woman presenting with symptoms of sepsis progressing to septic shock. Strategies for identifying and treating women with presumed sepsis are reviewed, and recent data regarding maternal and fetal outcomes are discussed...
May 7, 2018: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/29725629/acute-kidney-injury-in-pregnancy-the-changing-landscape-for-the-21st-century
#5
REVIEW
Swati Rao, Belinda Jim
Pregnancy-related acute kidney injury (Pr-AKI) remains a large public health problem, with decreasing incidences in developing countries but seemingly increasing incidences in the United States and Canada. These epidemiologic changes are reflective of the advances in medical and obstetric care, as well as changes in underlying maternal risk factors. The risk factors associated with advanced maternal age, such as hypertension, diabetes, chronic kidney disease, and those associated with reproductive technologies such as multiple gestations, are increasing...
March 2018: KI Reports
https://www.readbyqxmd.com/read/29678190/neonatal-and-congenital-malaria-a-case-series-in-malaria-endemic-eastern-uganda
#6
Peter Olupot-Olupot, Emma I E Eregu, Ketty Naizuli, Julie Ikiror, Linda Acom, Kathy Burgoine
BACKGROUND: Congenital malaria is the direct infection of an infant with malaria parasites from their mother prior to or during birth. Neonatal malaria is due to an infective mosquito bite after birth. Neonatal and congenital malaria (NCM) are potentially life-threatening conditions that are believed to occur at relatively low rates in malaria endemic regions. However, recent reports suggest that the number of NCM cases is increasing, and its epidemiology remains poorly described. NCM can mimic other neonatal conditions and because it is thought to be rare, blood film examinations for malaria are not always routinely performed...
April 20, 2018: Malaria Journal
https://www.readbyqxmd.com/read/29642754/daily-gentamicin-using-ideal-body-weight-demonstrates-lower-risk-of-postpartum-endometritis-and-increased-chance-of-successful-outcome-compared-with-traditional-8-hour-dosing-for-the-treatment-of-intrapartum-chorioamnionitis
#7
Daniel Martingano, Audrey Renson, Sharon Rogoff, Shailini Singh, Meera Kesavan Nasir, Juliette Kim, Jeanne Carey
BACKGROUND: Clinical chorioamnionitis complicates approximately 1-4% of pregnancies overall. Although universal agreement does not exist regarding the antibiotic regimen of choice, most studies have evaluated intravenous ampicillin dosed at 2 g every 6 hours plus gentamicin dosed every 8 hours. Only three studies have examined daily gentamicin for the treatment of intrapartum chorioamnionitis and thus is insufficiently investigated. OBJECTIVE: This study seeks to determine whether daily dosing of gentamicin using ideal body weight for the treatment of intrapartum chorioamnionitis is more or equivalently efficacious when compared to traditional 8-hour dosing regimens...
April 12, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29571592/risk-of-maternal-mortality-in-women-with-severe-anaemia-during-pregnancy-and-post-partum-a-multilevel-analysis
#8
Jahnavi Daru, Javier Zamora, Borja M Fernández-Félix, Joshua Vogel, Olufemi T Oladapo, Naho Morisaki, Özge Tunçalp, Maria Regina Torloni, Suneeta Mittal, Kapila Jayaratne, Pisake Lumbiganon, Ganchimeg Togoobaatar, Shakila Thangaratinam, Khalid S Khan
BACKGROUND: Anaemia affects as many as half of all pregnant women in low-income and middle-income countries, but the burden of disease and associated maternal mortality are not robustly quantified. We aimed to assess the association between severe anaemia and maternal death with data from the WHO Multicountry Survey on maternal and newborn health. METHODS: We used multilevel and propensity score regression analyses to establish the relation between severe anaemia and maternal death in 359 health facilities in 29 countries across Latin America, Africa, the Western Pacific, eastern Mediterranean, and southeast Asia...
May 2018: Lancet Global Health
https://www.readbyqxmd.com/read/29526138/comparison-between-two-doses-of-betamethasone-administration-with-12-hours-vs-24-hours-intervals-on-prevention-of-respiratory-distress-syndrome-a-randomised-trial
#9
Maryam Kashanian, Nooshin Eshraghi, Narges Sheikhansari, Arash Bordbar, Elahehsadat Khatami
The purpose of the present study was to compare the effect of a two-dose administration of betamethasone with 12 hours interval vs. 24 hours interval on neonatal respiratory distress syndrome (RDS). The study was performed as a randomised clinical trial on 201 pregnant women with a gestational age of 26-34 weeks. In one group 12 mg of betamethasone every 12 hours for two doses and in the other group 12 mg of betamethasone every 24 hours for two doses were prescribed intramuscularly. There were no significant differences between the two groups according to maternal age, parity, gravidity, BMI, neonatal sex, need to surfactant, NICU admission, NICU stay, neonatal death, neonatal sepsis and Apgar score at minutes 1 and 5, but the gestational age at the beginning of the study and delivery receiving complete course of betamethasone and neonatal weight were lower in 24 hours group...
March 12, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29460453/severe-maternal-morbidity-due-to-sepsis-the-burden-and-preventability-of-disease-in-new-zealand
#10
Sam Lepine, Beverley Lawton, Stacie Geller, Peter Abels, Evelyn J MacDonald
BACKGROUND: Sepsis is a life-threatening systemic condition that appears to be increasing in the obstetric population. Clinical detection can be difficult and may result in increased morbidity via delays in the continuum of patient care. AIMS: To describe the burden of severe maternal morbidity (SMM) caused by sepsis in New Zealand and investigate the potential preventability. METHODS: A multidisciplinary expert review panel was established to review cases of obstetric sepsis admitted to intensive care or high-dependency units over an 18 month span in New Zealand...
February 20, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29398054/severe-neurodevelopmental-impairment-in-neonates-born-preterm-impact-of-varying-definitions-in-a-canadian-cohort
#11
Matthew D Haslam, Sarka Lisonkova, Dianne Creighton, Paige Church, Junmin Yang, Prakesh S Shah, K S Joseph, Anne Synnes
OBJECTIVE: To assess the impact of variations in the definition of severe neurodevelopmental impairment (NDI) on the incidence of severe NDI and the association with risk factors using the Canadian Neonatal Follow-Up Network cohort. STUDY DESIGN: Literature review of severe NDI definitions and application of these definitions were performed in this database cohort study. Infants born at 23-28 completed weeks of gestation between 2009 and 2011 (n = 2187) admitted to a Canadian Neonatal Network neonatal intensive care unit and assessed at 21 months' corrected age were included...
February 2, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29361936/vaginal-dysbiosis-increases-risk-of-preterm-fetal-membrane-rupture-neonatal-sepsis-and-is-exacerbated-by-erythromycin
#12
Richard G Brown, Julian R Marchesi, Yun S Lee, Ann Smith, Benjamin Lehne, Lindsay M Kindinger, Vasso Terzidou, Elaine Holmes, Jeremy K Nicholson, Phillip R Bennett, David A MacIntyre
BACKGROUND: Preterm prelabour rupture of the fetal membranes (PPROM) precedes 30% of preterm births and is a risk factor for early onset neonatal sepsis. As PPROM is strongly associated with ascending vaginal infection, prophylactic antibiotics are widely used. The evolution of vaginal microbiota compositions associated with PPROM and the impact of antibiotics on bacterial compositions are unknown. METHODS: We prospectively assessed vaginal microbiota prior to and following PPROM using MiSeq-based sequencing of 16S rRNA gene amplicons and examined the impact of erythromycin prophylaxis on bacterial load and community structures...
January 24, 2018: BMC Medicine
https://www.readbyqxmd.com/read/29240754/maternal-death-review-and-outcomes-an-assessment-in-lagos-state-nigeria
#13
Friday Okonofua, Donald Imosemi, Brian Igboin, Adegboyega Adeyemi, Chioma Chibuko, Adewale Idowu, Wilson Imongan
The objective of the study was to investigate the results of Maternal and Perinatal Death Surveillance and Response (MPDSR) conducted in three referral hospitals in Lagos State, Nigeria over a two-year period and to report the outcomes and the lessons learned. MPDRS panels were constituted in the three hospitals, and beginning from January 2015, we conducted monthly MPDSR in the three hospitals using a nationally approved protocol. Data on births and deaths and causes of deaths as identified by the MPDSR panels were collated in the hospitals...
2017: PloS One
https://www.readbyqxmd.com/read/29228827/conservative-versus-active-management-in-hellp-syndrome-results-from-a-cohort-study
#14
Marie Cavaignac-Vitalis, Fabien Vidal, Caroline Simon-Toulza, Pierre Boulot, Paul Guerby, Elodie Chantalat, Olivier Parant
OBJECTIVE: HELLP syndrome exposes to severe maternal and fetal complications. Prompt delivery is thus recommended after 34 weeks of gestation, or earlier in case of nonreassuring maternofetal conditions. However, no consensus has been raised in the treatment of HELLP syndrome occurring before 34 weeks of gestation, when both maternal and fetal conditions are stable: it remains still unclear whether an active attitude should be prioritized over expectant management. Herein, we aimed to compare mother and child outcomes according to the type of obstetrical management, either active or conservative...
December 21, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29215155/prophylactic-antibiotics-before-cord-clamping-in-cesarean-delivery-a-systematic-review
#15
REVIEW
Claudia Bollig, Monika Nothacker, Cornelius Lehane, Edith Motschall, Britta Lang, Joerg J Meerpohl, Christine M Schmucker
INTRODUCTION: The number of clinical trials investigating the optimal timing of prophylactic antibiotics in cesarean section has increased rapidly over the last few years. We conducted a systematic review to inform up-to-date evidence-based guidelines to prevent postpartum infectious morbidity in the mother and rule out any safety issues related to antepartum antibiotic exposure in infants. MATERIAL AND METHODS: Four bibliographic databases were searched for published reports of trials...
May 2018: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/29203386/procalcitonin-the-marker-of-pediatric-bacterial-infection
#16
Mohammad Yousef Memar, Mojtaba Varshochi, Behrooz Shokouhi, Mohammad Asgharzadeh, Hossein Samadi Kafil
Timely recognition of systemic bacterial infections in pediatric care setting is the basis for effective treatment and control. This review provides an overview of procalcitonin (PCT) as an early marker for the detection of severe, invasive bacterial infection in children. Almost all articles on biochemical property and clinical studies in PubMed and Scopus databases regarding their use in pediatric infections and the use of PCT as a marker of bacterial infections were examined. Various methods and analyzers are currently available for the evaluation of PCT...
December 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/29143618/using-the-missed-opportunity-tool-as-an-application-of-the-lives-saved-tool-list-for-intervention-prioritization
#17
Yvonne Tam, Luwei Pearson
BACKGROUND: The Missed Opportunity tool was developed as an application in the Lives Saved Tool (LiST) to allow users to quickly compare the relative impact of interventions. Global Financing Facility (GFF) investment cases have been identified as a potential application of the Missed Opportunity analyses in Democratic Republic of the Congo (DRC), Ethiopia, Kenya, and Tanzania, to use 'lives saved' as a normative factor to set priorities. METHODS: The Missed Opportunity analysis draws on data and methods in LiST to project maternal, stillbirth, and child deaths averted based on changes in interventions' coverage...
November 7, 2017: BMC Public Health
https://www.readbyqxmd.com/read/29108905/-maternal-deaths-due-to-infectious-cause-results-from-the-french-confidential-enquiry-into-maternal-deaths-2010-2012
#18
A Rigouzzo, V Tessier, L Zieleskiewicz
Over the period 2010-2012, maternal mortality from infectious causes accounted for 5% of maternal deaths by direct causes and 16% of maternal deaths by indirect causes. Among the 22 deaths caused by infection occurred during this period, 6 deaths were attributed to direct causes from genital tract origin, confirming thus the decrease in direct maternal deaths by infection during the last ten years. On the contrary, indirect maternal deaths by infection, from extragenital origin, doubled during the same period, with 16 deaths in the last triennium, dominated by winter respiratory infections, particularly influenza: the 2009-2010 influenza A (H1N1) virus pandemic was the leading cause of indirect maternal mortality by infection during the studied period...
December 2017: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/29022924/listeriosis-in-pregnancy-under-diagnosis-despite-over-treatment
#19
Y Fouks, S Amit, A Many, A Haham, D Mandel, S Shinar
OBJECTIVE: To compare the symptomatology of pregnant women with suspected listeriosis to culture confirmed listeriosis. STUDY DESIGN: All cases of suspected and culture confirmed pregnancy-associated listeriosis from a single center were retrospectively reviewed assessing demographics, clinical, laboratory and pathological findings, and maternal, fetal and neonatal outcomes. RESULTS: Listeriosis was identified in seven patients, none of whom belonged to the 117 women with suspected listeriosis...
January 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28870155/pessary-or-progesterone-to-prevent-preterm-delivery-in-women-with-short-cervical-length-the-quadruple-p-randomised-controlled-trial
#20
Maud D van Zijl, Bouchra Koullali, Christiana A Naaktgeboren, Ewoud Schuit, Dick J Bekedam, Etelka Moll, Martijn A Oudijk, Wilhelmina M van Baal, Marjon A de Boer, Henricus Visser, Joris van Drongelen, Flip W van de Made, Karlijn C Vollebregt, Moira A Muller, Mireille N Bekker, Jozien T J Brons, Marieke Sueters, Josje Langenveld, Maureen T Franssen, Nico W Schuitemaker, Erik van Beek, Hubertina C J Scheepers, Karin de Boer, Eveline M Tepe, Anjoke J M Huisjes, Angelo B Hooker, Evelyn C J Verheijen, Dimitri N Papatsonis, Ben Willem J Mol, Brenda M Kazemier, Eva Pajkrt
BACKGROUND: Preterm birth is in quantity and in severity the most important topic in obstetric care in the developed world. Progestogens and cervical pessaries have been studied as potential preventive treatments with conflicting results. So far, no study has compared both treatments. METHODS/DESIGN: The Quadruple P study aims to compare the efficacy of vaginal progesterone and cervical pessary in the prevention of adverse perinatal outcome associated with preterm birth in asymptomatic women with a short cervix, in singleton and multiple pregnancies separately...
September 4, 2017: BMC Pregnancy and Childbirth
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